Drug Therapy Problem and its Contributing Factors among Pediatric patients with Infectious Diseases admitted to Jimma University Medical Center, South West Ethiopia: Prospective observational study

Desalegn Feyissa, Tsegaye Melaku, Dula Dessalegn
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Abstract

Background: Drug therapy problem is a significant challenge to provide high quality health care service for the patients. It is associated with morbidity, mortality, increased hospital stay and reduced quality of life. Moreover, pediatric patients are quite susceptible to drug therapy problems.Thus this study aimed to assess drug therapy problem and its contributing factors among pediatric patients diagnosed with infectious disease admitted to pediatric ward of Jimma university medical center, from April ,2018 to June 30, 2018. Methodology: Prospective observational study was conducted among pediatric patients with infectious disease admitted to Jimma university medical center from April 01,2018 to June 30, 2018. Drug therapy problems were identified by using Cipolle’s and strand’s drug therapy problem classification method. Patient’s written informed consent was obtained after explaining the purpose of the study. Patient’s specific data were collected using structured questionnaire. Data was entered into Epi data version 4.0.2 and then exported to statistical software package version 21.0 for analysis. To identify predictors of drug therapy problems occurrence, multiple stepwise backward logistic regression analysis were done. The 95% CI was used to show the accuracy of data analysis and statistical significance was considered at p-value <0.05. Results: A total of 304 pediatric patients were included in the study. Of these, 226(74.3%) patients had at least one drug therapy problem during their hospital stay. A total of 356 drug therapy problems were identified among two hundred twenty six patients. Non-compliance (28.65%) and dose too low (27.53%) were the most common type of drug therapy problems while disease comorbidity [AOR=3.39, 95% CI= (1.89-6.08)], Polypharmacy [AOR=3.16, 95% CI= (1.61-6.20)] and more than six days stay in hospital [AOR=3.37, 95% CI= (1.71-6.64) were independent predictors of drug therapy problem occurrence. Conclusion and recommendation: Drug therapy problems were common in pediatric patients with infectious disease in the study area. Presence of comorbidity, Polypharmacy and Prolonged hospital stay were the predictors of drug therapy problem in this finding. Therefore, to overcome the significant gaps in pediatric pharmaceutical care, clinical pharmacists, Pediatricians and other health care professional have to work in collaboration. Keywords: Drug therapy problem, Pediatric, infectious disease, Ethiopia
埃塞俄比亚西南部吉玛大学医学中心收治的感染性儿科患者的药物治疗问题及其影响因素:前瞻性观察研究
背景:药物治疗问题是为患者提供高质量医疗服务的一个重大挑战。它与发病率、死亡率、住院时间延长和生活质量下降有关。此外,儿科患者很容易受到药物治疗问题的影响。因此,本研究旨在评估2018年4月至2018年6月30日吉马大学医学中心儿科病房收治的诊断为感染性疾病的儿科患者的药物治疗问题及其影响因素。方法:对2018年4月1日至2018年6月30日在吉马大学医学中心住院的儿科感染性疾病患者进行前瞻性观察研究。采用Cipolle和strand的药物治疗问题分类方法对药物治疗问题进行识别。在解释研究目的后获得患者的书面知情同意。采用结构化问卷法收集患者具体资料。数据输入Epi数据版本4.0.2,导出到统计软件包版本21.0进行分析。为确定药物治疗问题发生的预测因素,采用多元逐步logistic回归分析。以95% CI表示数据分析的准确性,p值<0.05认为具有统计学意义。结果:本研究共纳入304例儿科患者。其中,226例(74.3%)患者在住院期间至少有一次药物治疗问题。在226例患者中,共发现356个药物治疗问题。不依从性(28.65%)和剂量过低(27.53%)是最常见的药物治疗问题类型,疾病合并症[AOR=3.39, 95% CI=(1.89 ~ 6.08)]、多药治疗[AOR=3.16, 95% CI=(1.61 ~ 6.20)]和住院时间超过6天[AOR=3.37, 95% CI=(1.71 ~ 6.64)]是药物治疗问题发生的独立预测因素。结论与建议:在研究地区,儿童感染性疾病患者的药物治疗问题较为普遍。合并症的存在、多种用药和延长住院时间是药物治疗问题的预测因素。因此,要克服儿科药学服务的显著差距,临床药师、儿科医生和其他卫生保健专业人员必须协同工作。关键词:药物治疗问题,儿科,传染病,埃塞俄比亚
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